Interventions to Reduce Health Disparities in Youth of Dual Protection

减少双重保护青少年健康差异的干预措施

• 批准号: 8770908
• 负责人: MELISSA L. GILLIAM
• 金额: $ 24.37万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-19 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8770908
• 关键词: Abortion Rates; Accounting; Address; Adherence; Adopted; African American; Age; Behavior; Behavioral; Belief; Birth; Chicago; Chlamydia; Clinic; Clinical Trials Design; Communication; Conceptions; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Counseling; Education; Educational Materials; Effectiveness; Effectiveness of Interventions; Elements; Failure; Focus Groups; Gonorrhea; Grant; HIV; HIV Infections; Health; Implant; Individual; Infertility; Injectable; Intervention; Intrauterine Devices; Knowledge; Life; Low income; Maintenance; Methods; Modeling; Morbidity - disease rate; Multimedia; Outcome; Participant; Patients; Phase; Planning Theory; Population; Pre-Post Tests; Preparation; Prevention strategy; Printing; Professional counselor; Randomized Controlled Trials; Relapse; Reproductive Health; Research; Risk Reduction; Self Efficacy; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Site; Staging; Tablets; Testing; Time; Training; Woman; Youth; base; behavior change; condoms; design; digital; experience; health disparity; health economics; improved; infant outcome; innovation; interest; member; mobile application; mortality; motivational enhancement therapy; novel; peer; pregnancy prevention; prevent; public health relevance; racial and ethnic; theories; unintended pregnancy; young woman

DESCRIPTION (provided by applicant): Preventing sexually transmitted infections including HIV (STI/HIV) and unintended pregnancies is critical to improving sexual and reproductive health and life outcomes for African Americans. The reproductive health disparities are severe. There is a need for novel interventions that address the unique challenges faced by young African American women, contextualizing both STI/HIV and pregnancy prevention efforts within their lives. The proposed research promotes dual protection, combining condoms with a highly effective contraceptive (e.g., intrauterine device, implant, injectable), by framing behavioral targets in terms of risk reduction, helping young women adopt optimal (e.g., "dual method") as well as suboptimal but effective behaviors (e.g., condoms alone -a single method that offers "dual protection"). The multimedia counseling intervention miPlan operationalizes the Transtheoretical Model and the Theory of Planned Behavior in order to encourage behavior change. In addition, motivational interviewing will inform the contraceptive counseling women receive and concomitant printed educational materials will help women maintain and prevent relapse for new behaviors. The project will proceed in two phases. In Phase I, we will assemble a 10-member stakeholder advisory team to adapt the PreCounselor app, originally developed as part of a grant from the Office of Population Affairs, to focus on dual protection. We will train reproductive health counselors and create concomitant printed educational materials. In Phase II, the feasibility, acceptability, and effectiveness of the intervention will be assessed through pre- and post-testing examining improvement in dual method use, enhancement of contraception adherence and continuation, increase of condom use, and decrease of STI/HIV infection. We hypothesize the young African American women who use the miPlan app will find it to be comprehensive, culturally tailored, and engaging, and that participation in the intervention will ultimately improve dual method use, contraceptive adherence and continuation, and decrease STI/HIV infection. If proven to be feasible and effective, a subsequent R01 application will be submitted to assess miPlan using a large-scale multiple clinic site RCT design.

描述（由申请人提供）：预防包括艾滋病毒 (STI/HIV) 在内的性传播感染和意外怀孕对于改善非裔美国人的性健康和生殖健康以及生活结果至关重要。生殖健康方面的差距十分严重。需要采取新的干预措施来解决年轻的非洲裔美国妇女面临的独特挑战，将性传播感染/艾滋病毒和怀孕预防工作纳入她们的生活中。拟议的研究促进双重保护，将安全套与高效避孕药具（例如宫内节育器、埋植剂、注射剂）相结合，通过制定降低风险的行为目标，帮助年轻女性采用最佳避孕方法（例如“双重方法”）作为次优但有效的行为（例如，单独使用安全套 - 提供“双重保护”的单一方法）。多媒体咨询干预 miPlan 运用跨理论模型和计划行为理论来鼓励行为改变。此外，动机性访谈将告知女性接受的避孕咨询，同时印刷的教育材料将帮助女性维持新行为并防止旧病复发。该项目将分两个阶段进行。在第一阶段，我们将组建一个由 10 名利益相关者组成的咨询团队，对 PreCounselor 应用程序进行调整，该应用程序最初是作为人口事务办公室拨款的一部分开发的，以重点关注双重保护。我们将培训生殖健康顾问并制作相应的印刷教育材料。在第二阶段，将通过测试前和测试后检查双重方法使用的改进、避孕依从性和持续性的增强、安全套使用的增加以及性传播感染/艾滋病毒感染的减少来评估干预措施的可行性、可接受性和有效性。我们假设使用 miPlan 应用程序的年轻非洲裔美国女性会发现它是全面的、根据文化量身定制的且具有吸引力，并且参与干预最终将改善双重方法的使用、避孕的依从性和持续性，并减少性传播感染/艾滋病毒感染。如果被证明可行且有效，将提交后续的 R01 申请，以使用大规模多临床站点 RCT 设计来评估 miPlan。